Role OverviewThe Claims Service Advocate is responsible for reviewing moderately complex health insurance claims and provides customer service to members, providers, and/or customers. This position determines how to apply benefits and whether to return, deny, or pay claims following organizational policies and procedures.
What You Will Do
Reviews moderately complex claims, responds to incoming reports, medical records, and other related documents, and provides information, guidance, and education to members and customers.
Why It Might Be a Fit
A problem solver with the ability to research, analyze and define methods, practices, and procedures to resolve issues, ability to communicate clearly and professionally, and a strong ability to prioritize and organize work.
Requirements
- High School Diploma/GED
- 3 years of experience in customer service, claims processing or related experience
- Problem solving skills
- Ability to communicate clearly and professionally
- Ability to work effectively with others
- Creative mindset
- Prioritization and organization skills
Benefits
- Affordable medical, dental and vision coverage
- Employer funded Lifestyle Spending Accounts, Health Savings Accounts and Health Reimbursement Arrangements
- Employer-paid life and disability insurance
- 401(k) retirement plan with company match and immediate vesting
- Paid holidays, paid time off (PTO), PTO donation program, and paid parental leave
- Voluntary benefits including Accident, Hospital Indemnity, Critical Illness, Term/Whole Life, Cancer Care Insurance, and more
- 16 hours of paid volunteer time with a $200 donation to a charity of your choice
- Employee recognition, community initiative events and yearly company outings
- Workplace flexibility
- Comprehensive learning and development opportunities
- Robust mental health offerings
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